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Karin Kofler, Matthias Bolz, Bernhard Baumann, Stefan Zotter, Ferdinand Schlanitz, Philipp Roberts, Michael Pircher, Markus Ritter, Christoph Hitzenberger, Ursula Schmidt-Erfurth, ; Characteristic findings of retinitis pigmentosa in polarization sensitive optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1477.
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Retinitis pigmentosa(RP) is a clinical and genetic heterogenic group of retinal diseases affecting rods and cones. Molecular investigations have shown that some of the responsible genes for RP are expressed in the photoreceptors and some in the retinal pigment epithelium (RPE). RPE and photoreceptors were analyzed by PS-OCT which is specially suited to reveal the integrity of the RPE. Thereby we expect to get further insight into pathomorphology and -physiology.
Twelve eyes of six patients with RP were imaged using a prototype of a PS OCT device. After obtaining best-corrected visual acuity (BCVA), the integrity of the RPE was evaluated using autofluorescence angiography (AFA), spectral domain OCT (Spectralis HRA+OCT) and PS-OCT.
Some patients showed a hyperautofluorescent ring in AFA. In all patients of this group the outer layers representing the photoreceptors (inner-outer segment line, outer nuclear layer) were found in the foveal center. In SD OCT the reflectivity of the RPE lying beneath these still present photoreceptors did not differ from those areas around the fovea without photoreceptors. However, PS-OCT revealed a significant difference in the integrity of the RPE according to the scanning location. The hyperreflective area in AFA correlated with the border between preserved and irregular or absent RPE. Regarding the extension of the area of RPE alteration, there was a good correspondence between AFA and PS OCT-maps. In patients with a central accumulation of depolarizing RPE clusters no inner-outer segment line was found and the peripheral RPE was absent.
PS-OCT is capable of detecting the integrity of the RPE in cases of RP in a very precise way combining information that until now was obtained by two different techniques, SD-OCT and AFA. Based on this technique new insight into the condition of the RPE in the progression of RP can be gained and solid prognostic evaluation and new therapeutic strategies might be deducted.
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